Study of the value of core biopsy for establishing tissue diagnosis compared to excisional biopsy in enlarged cervical lymph nodes

Abstract

Background: Core tissue biopsy involves sampling tissue with a wider gauge than is used for fine-needle aspiration cytology. Core biopsy may be used as an alternative to surgical excisional lymph node biopsy as it would provide less risk to the patients as regards wound infection, scar, bleeding, accessory nerve injury, and the risk of complications of general anesthesia. The aim of this work was to assess the accuracy, specificity, and sensitivity of core biopsy in establishing tissue diagnosis of enlarged cervical lymph nodes. Patients and Methods: This prospective study was carried out on 100 patients, 50 for core biopsy and 50 for excisional biopsy, aged more than 18 years old, both sexes, with cervical lymphadenopathy indicated for ultrasonography (US)- guided core biopsy. Results: Based on our study, the diagnostic rate of core needle biopsy (CNB) is 53 cores and 10% of them need an excisional biopsy. 95% of lymphoma patients were diagnosed by core biopsies. Every CNB patient underwent hydrodissection and got a safe puncture distance. In cervical lymphadenopathy diagnosis, CNB had 89% sensitivity, 100% specificity, 100% positive predictive value, and 66% negative predictive value. Conclusion: Performing core samples of cervical lymph nodes in cases of cervical lymphadenopathy, especially US-guided core biopsy, can be beneficial in achieving a diagnosis as well as decreasing the need for excisional biopsies performed under general anesthesia.